CPT® Code 0288T

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Anoscopy with the delivery of thermal energy to the muscle of the anal canal is a specialized medical procedure primarily aimed at treating fecal incontinence. Fecal incontinence refers to the involuntary leakage of stool from the rectum and anal canal, which can significantly impact a patient's quality of life. During this procedure, thermal energy is applied through a hand-held anoscope, which is a tubular instrument designed for visualizing the anal canal. The patient is typically positioned in a prone-jackknife position to facilitate access to the anal area, and sedation is administered to ensure comfort throughout the procedure. Local anesthetic is also applied to minimize discomfort at the site of intervention. The anoscope is carefully inserted into the anal canal, reaching the dentate line, which is a critical anatomical landmark. Under direct visualization, four titanium needle electrodes are utilized to deliver radiofrequency energy to the targeted tissue for a duration of 90 seconds. This energy application creates thermal lesions in the muscle of the anal canal, which are monitored by thermocouples located at the tips and bases of the electrodes. These thermocouples continuously track the temperature of the treated tissue, ensuring that it does not exceed the preselected target of 185°F (85°C). The procedure involves creating multiple lesions, typically ranging from 16 to 20 applications, in 5 mm increments proximal to the dentate line. The ultimate goal of this intervention is to induce shrinkage and tightening of the anal muscles, thereby alleviating symptoms of incontinence and improving the patient's overall bowel control.